Spay/Neuter Voucher <<VoucherCode>>

Date: <<Date>>

<<Organisation>> promises to pay for the spay/neuter and, if any, the additional procedures listed below at                              Vet Clinic.

Name: <<AnimalName>>

Breed: <<BreedName>>

Sex: <<Sex>>

Color: <<BaseColorName>>

Microchip # if chipped:  <<MicrochipNumber>> 

Weight:  <<Weight>>

Age:  <<Age>>

This voucher is only good for:

Anesthesia needed for the actual spay/neuter surgery, the surgery itself, pain/antibiotic injection, suture removal and any additional procedures described below:

___________________________________

If this is not a shelter animal, the owner is responsible for any extra costs for other requested/elective procedures. The owner is also responsible for the costs of any pre anesthetic exam, all needed tests, vaccinations, additional hospital stays or medication (unless required for the above named procedure and authorized by the shelter).

Owner agrees to this by signing below:

_______________________________

Owner's Signature

_______________________________

Shelter Representative's Signature

For veterinarian's office use only:

Date of surgery:__________________________________

Veterinarian's signature:_______________________________